Problem Gambling Associated With Aripiprazole in First-Episode Psychosis Patients

Corbeil, Olivier; Corbeil, Stéphanie; Giroux, Isabelle; Jacques, Christian; Dorval, Michel; Demers, Marie-France; Roy, Marc‐André

doi:10.1097/jcp.0000000000001177

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…Furthermore, there also appeared to be an association between the occurrence of PBG and aripiprazole, a widely used antipsychotic drug for the treatment of FEP, which had already been reported in previous case reports [12,13]. Indeed, among the 14 FEP patients who developed PBG, 12 cases occurred during aripiprazole treatment, resulting in an adjusted odds ratio of 8.6 (p-value = .012).…”

Section: Introductionsupporting

confidence: 61%

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

Corbeil

Soulard

Huot-Lavoie

et al. 2023

Preprint

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Background The limited available data suggest that the prevalence of problem gambling is increased among young adults with first-episode psychosis, possibly due in part to several risk factors for problem gambling that are common in this population. Aripiprazole, a widely used antipsychotic drug, has also been linked to cases of problem gambling, but causality remains uncertain. Although the consequences of problem gambling further hinder the recovery of people with first-episode psychosis, there is a paucity of research about this comorbidity and its risk factors. Additionally, to our knowledge, no screening instrument for problem gambling tailored to these individuals exists, contributing to its under-recognition. Further, treatment approaches for problem gambling adapted to this population are at an embryonic stage, while existing treatments effectiveness remains to be documented. Using an innovative screening and assessment procedure for problem gambling, this study aims to identify risk factors for problem gambling among people with first-episode psychosis and to document the effectiveness of standard treatment approaches. Methods This is a multicenter prospective cohort study conducted in two first-episode psychosis clinics, including all patients admitted between November 1st, 2019, and November 1st, 2023, followed for up to 3 years until May 1st, 2024. These 2 clinics admit approximately 200 patients annually, for an expected sample size of 800 individuals. The primary outcome is the occurrence of a DSM-5 diagnosis of gambling disorder. All patients are screened and evaluated for problem gambling using a systematic procedure at admission, and every 6 months thereafter. Socio-demographic and clinical variables are prospectively extracted from the patients’ medical records. The nature and effectiveness of treatments for problem gambling offered to affected individuals are also documented from medical records. Survival analyses with Cox regression models will be used to identify potential risk factors for problem gambling. Descriptive statistics will document the effectiveness of treatments for problem gambling in this population. Discussion A better understanding of potential risk factors for problem gambling among people with first-episode psychosis will allow for better prevention and detection of this neglected comorbidity. Results of this study will also hopefully raise clinicians’ and researchers’ awareness and serve as the basis to adapted treatments that will better support recovery. Trial registration: ClinicalTrials.gov, NCT05686772. Retrospectively registered, 9 January 2023.

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Section: Introductionsupporting

confidence: 61%

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

Corbeil

Soulard

Huot-Lavoie

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…While these risk factors have mostly been documented in general population samples, there is a paucity of data specific to individuals with psychotic disorders. Furthermore, there also appeared to be an association between the occurrence of PBG and aripiprazole, a widely used antipsychotic drug for the treatment of FEP, which had already been reported in previous case reports [ 12 , 13 ]. Indeed, among the 14 FEP patients who developed PBG, 12 cases occurred during aripiprazole treatment, resulting in an adjusted odds ratio of 8.6 ( p -value = 0.012).…”

Section: Introductionsupporting

confidence: 59%

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background The limited available data suggest that the prevalence of problem gambling is increased among young adults with first-episode psychosis, possibly due in part to several risk factors for problem gambling that are common in this population. Aripiprazole, a widely used antipsychotic drug, has also been linked to cases of problem gambling, but causality remains uncertain. Although the consequences of problem gambling further hinder the recovery of people with first-episode psychosis, there is a paucity of research about this comorbidity and its risk factors. Additionally, to our knowledge, no screening instrument for problem gambling tailored to these individuals exists, contributing to its under-recognition. Further, treatment approaches for problem gambling adapted to this population are at an embryonic stage, while existing treatments effectiveness remains to be documented. Using an innovative screening and assessment procedure for problem gambling, this study aims to identify risk factors for problem gambling among people with first-episode psychosis and to document the effectiveness of standard treatment approaches. Methods This is a multicenter prospective cohort study conducted in two first-episode psychosis clinics, including all patients admitted between November 1st, 2019, and November 1st, 2023, followed for up to 3 years until May 1st, 2024. These 2 clinics admit approximately 200 patients annually, for an expected sample size of 800 individuals. The primary outcome is the occurrence of a DSM-5 diagnosis of gambling disorder. All patients are screened and evaluated for problem gambling using a systematic procedure at admission, and every 6 months thereafter. Socio-demographic and clinical variables are prospectively extracted from the patients’ medical records. The nature and effectiveness of treatments for problem gambling offered to affected individuals are also documented from medical records. Survival analyses with Cox regression models will be used to identify potential risk factors for problem gambling. Descriptive statistics will document the effectiveness of treatments for problem gambling in this population. Discussion A better understanding of potential risk factors for problem gambling among people with first-episode psychosis will allow for better prevention and detection of this neglected comorbidity. Results of this study will also hopefully raise clinicians’ and researchers’ awareness and serve as the basis to adapted treatments that will better support recovery. Trial registration ClinicalTrials.gov, NCT05686772. Retrospectively registered, 9 January 2023.

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“…There have also been reports of impulse control disorders and PBG with the use of certain antipsychotic treatments, that is, partial dopamine agonists (i.e., aripiprazole, brexpiprazole, and cariprazine), although a causal association remains uncertain. 64,[76][77][78][79]…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

Problem gambling in psychotic disorders: A systematic review and meta‐analysis of prevalence

Corbeil,

Anderson,

Béchard

et al. 2024

Acta Psychiatr Scand

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IntroductionProblem gambling (PBG) is more common in people with mental health disorders, including substance use, bipolar, and personality disorders, than in the general population. Although individuals with psychotic disorders might be expected to be more vulnerable to PBG, fewer studies have focused on this comorbidity. The aim of this review was to estimate the prevalence of PBG in people with psychotic disorders.MethodsMedline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of science, and ProQuest were searched on November 1, 2023, without language restrictions. Observational and experimental studies including individuals with psychotic disorders and reporting the prevalence of PBG were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal for systematic reviews of prevalence data. The pooled prevalence of PBG was calculated using a fixed effects generalized linear mixed model and presented through forest plots.ResultsOf 1271 records screened, 12 studies (n = 3443) were included. The overall prevalence of PBG was 8.7% (95% CI = 7.8%–9.7%, I2 = 69%). A lower prevalence was found in studies with a low risk of bias (5.6%; 95% CI = 4.4%–7.0%) compared with studies with a moderate risk of bias (10.4%; 95% CI = 9.2%–11.7%). Different methods used to assess PBG also contributed to the heterogeneity found.ConclusionThis meta‐analysis found substantial heterogeneity, partly due to the risk of bias of the included studies and a lack of uniformity in PBG assessment. Although more research is needed to identify those at increased risk for PBG, its relatively high prevalence warrants routine screening for gambling in clinical practice.

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Problem Gambling Associated With Aripiprazole in First-Episode Psychosis Patients

Cited by 10 publications

References 15 publications

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

Problem gambling among people with first-episode psychosis: protocol for a prospective multicenter cohort study

Problem gambling in psychotic disorders: A systematic review and meta‐analysis of prevalence

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